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E.M. Aring, S. Andersson, J. Ygge, A. Hellström; Visual Acuity, Refraction, Strabismus And Ocular Motility in Children With Surgically Treated Hydrocephalus. Is There a Difference Between Children Without or With Myelomeningocele . Invest. Ophthalmol. Vis. Sci. 2005;46(13):655.

Abstract: :
Purpose: To compare visual acuity (VA), refractive errors, strabismusand ocular motility in a population–based group of childrenwith surgically treated hydrocephalus according to the associationwith myelomeningocele (MMC) or not (HC).Methods: All children (n=92) with surgically treated hydrocephalusborn 1989–1993 in the western part of Sweden were invitedto participate in a multidisciplinary study. Seventy–fivechildren, (MMC; n=28; HC; n=47) (34 girls, 41 boys, median age9.7 years (range 7.2–12.8 y) were enrolled in the ophthalmologicalinvestigations which included binocular linear VA, cover test,ocular motility (versions and ductions) and retinoscopy (autorefractor)in cycloplegia.Results: Binocular best–corrected VA was less than 0.3(>0.5 log MAR) in 15% of the HC children but in none of theMMC children (p=0.0035). There was no significant differencefound between the groups in VA between 0.3 and 0.65 (0.5 to0.2 log MAR) nor did the occurrence of refractive errors differ.The occurrence of hypermetropia (≥+2.5 D) was 46%, myopia (≤–0.5D) 10% and astigmatism (0.75 D) was 11%. Heterotropia was foundin 68% (ns) and esotropia was the most common type (ns). However,there was a trend to more exotropia in the HC group 36% comparedto 14% in the MMC group (p=0.0924). Ocular motility problems(versions and ductions) occurred in 18% and 59% respectively;equally in both groups and the ductions of the oblique muscleswere the most affected.Conclusions: Low VA was significant more common among childrenwith HC. However, refraction, the occurrence of strabismus andocular motility problems did not differ significantly betweenthe HC and the MMC children.